•Organic species and concentrations are critical factors for anammox-based process.•PN/A-based process with different operational strategies needed further exploration.•Effect of residual organics from A-stage is need concerned applying of sewage PN/A.•PN/A-based process combined with denitrification may be an effective process.•Influent organics could be an essential factor for successful application of sewage PN/A. Partial nitrification-anammox (PN/A) is an energy-efficient process for nitrogen removal from sewage. The influent organics of sewage is usually pre-removed, reducing the risk for enriching anammox bacteria (AnAOB). However, recent studies demonstrate that optimum influent organics could improve nitrogen removal and operational stability of PN/A. Thus, the impact of organics on PN/A-based process should not be overlooked. In this review, the complicated impacts of organics-containing influent on anammox and their linking to apply PN/A are discussed. Firstly, the effect of organics on AnAOB metabolism and the competition relationship between AnAOB and heterotrophic bacteria are summarized. Secondly, the combined effects of influent organics and operational strategies on PN/A-based process were reviewed. Thirdly, how to control influent organics in the real application of PN/A were discussed. Lastly, recent development of the PN/A-based process combined with denitrification were reviewed. Overall, influent organics could be an essential factor for successful application of sewage PN/A.